1
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Christensen D, Tuluc M, Faro SH, Udare A, Gargano S. Sinonasal Oxalosis due to Fungal Rhinosinusitis: A Unique Case of a Destructive Pseudotumor. Int J Surg Pathol 2024; 32:601-606. [PMID: 37424352 DOI: 10.1177/10668969231185073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Oxalosis refers to the accumulation of calcium oxalate crystals in various organs and tissues, most commonly due to Aspergillus infection involving the lung or sinonasal tract. Both invasive and noninvasive forms of fungal rhinosinusitis can be associated with calcium oxalate crystal deposition. Here, we report a unique case of sinonasal oxalosis presenting as a destructive lesion in the absence of invasive fungal disease. Due to the clinical and pathologic significance of calcium oxalate crystals as seen in this patient, specimens from the sinonasal tract should be evaluated for the presence of these crystals, which may be a surrogate marker for fungal infection and may also independently cause tissue destruction.
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Affiliation(s)
- Daniel Christensen
- Department of Surgical Pathology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Madalina Tuluc
- Department of Surgical Pathology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Scott H Faro
- Department of Radiology and Neurology, Division of Neuroradiology and ENT, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ashlesha Udare
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Stacey Gargano
- Department of Surgical Pathology, Thomas Jefferson University, Philadelphia, PA, USA
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2
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Meyer SN, Le S, Caro-Chang LA, Awasthi S, Fung MA, Kiuru M. Localized calcium oxalate crystals in primary cutaneous aspergillosis. J Cutan Pathol 2024; 51:88-91. [PMID: 37699723 PMCID: PMC10872998 DOI: 10.1111/cup.14533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/18/2023] [Accepted: 08/27/2023] [Indexed: 09/14/2023]
Abstract
Select Aspergillus species can produce oxalate as a fermentation byproduct, which may react with calcium ions to produce insoluble calcium oxalate crystals in tissues. These crystals are frequently associated with pulmonary Aspergillus infections, yet are rarely described in primary cutaneous aspergillosis. Herein, we report the presence of calcium oxalate crystals detected on cutaneous specimens from primary cutaneous Aspergillus niger and Aspergillus fumigatus infections in an immunocompromised, premature infant. No metabolic sources of oxalosis were found.
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Affiliation(s)
- Summer N. Meyer
- Department of Dermatology, University of California Davis School of Medicine, Sacramento CA, USA
| | - Stephanie Le
- Department of Dermatology, University of California Davis School of Medicine, Sacramento CA, USA
| | - Leah Antoinette Caro-Chang
- Department of Dermatology, University of California Davis School of Medicine, Sacramento CA, USA
- Department of Laboratory and Pathology Medicine, University of California Davis School of Medicine, Sacramento CA, USA
| | - Smita Awasthi
- Department of Dermatology, University of California Davis School of Medicine, Sacramento CA, USA
| | - Maxwell A. Fung
- Department of Dermatology, University of California Davis School of Medicine, Sacramento CA, USA
- Department of Laboratory and Pathology Medicine, University of California Davis School of Medicine, Sacramento CA, USA
| | - Maija Kiuru
- Department of Dermatology, University of California Davis School of Medicine, Sacramento CA, USA
- Department of Laboratory and Pathology Medicine, University of California Davis School of Medicine, Sacramento CA, USA
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3
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Kubota Y, Takasawa A, Ono Y, Aoyama T, Takasawa K, Tada A, Magara K, Murakami T, Daimon F, Yamamoto S, Sato S, Hiratsuka Y, Kyuno D, Osanai M. Invasive pulmonary aspergillosis with candidiasis: usefulness of molecular and ultrastructural morphological analysis on FFPE tissue for invasive fungal infections. Med Mol Morphol 2023; 56:144-151. [PMID: 36806624 PMCID: PMC9940076 DOI: 10.1007/s00795-023-00349-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/06/2023] [Indexed: 02/23/2023]
Abstract
Invasive pulmonary aspergillosis (IPA) is one of the most frequent forms of invasive fungal infections (IFI); however, it is often difficult to identify the pathogenic fungal species and to select appropriate treatments for patients with IFI including IPA. Here, we describe the detailed pathophysiology of an autopsy case of severe respiratory failure due to IPA with candidiasis. The patient developed severe respiratory failure after influenza infection and died, and the autopsy revealed a mixed disease of IPA with candidiasis. In this study, in addition to the routine pathological examination, we further examined formalin-fixed paraffin-embedded (FFPE) tissues by scanning electron microscopy (SEM) and partial genomic DNA sequencing. Although optical microscopy alone was insufficient to identify the pathogenic organisms, SEM clearly depicted the characteristic morphology of Aspergillus sp. and Candida sp. as closely overlapping in a nested fashion, providing evidence of mixed infection of both fungal species in a focal site. The technique using FFPE tissue in combination with ultrastructural observation by SEM, elemental analysis by SEM-EDX, and DNA sequencing is promising for analyzing the pathophysiology of IFI.
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Affiliation(s)
- Yusaku Kubota
- Department of Pathology, Sapporo Medical University School of Medicine, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Akira Takasawa
- Department of Pathology, Sapporo Medical University School of Medicine, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan.
| | - Yusuke Ono
- Department of Pathology, Sapporo Medical University School of Medicine, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Tomoyuki Aoyama
- Department of Pathology, Sapporo Medical University School of Medicine, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Kumi Takasawa
- Department of Pathology, Sapporo Medical University School of Medicine, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Akinori Tada
- Department of Pathology, Sapporo Medical University School of Medicine, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Kazufumi Magara
- Department of Pathology, Sapporo Medical University School of Medicine, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Taro Murakami
- Department of Pathology, Sapporo Medical University School of Medicine, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Fuminori Daimon
- Department of Pathology, Sapporo Medical University School of Medicine, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Soh Yamamoto
- Department of Microbiology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shota Sato
- Emergency and Critical Care Center, Hakodate Municipal Hospital, Hakodate, Japan
| | - Yutaro Hiratsuka
- Department of Pathology, Sapporo Medical University School of Medicine, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
- Department of Internal Medicine, Kin-ikyo Chuo Hospital, Sapporo, Japan
| | - Daisuke Kyuno
- Department of Pathology, Sapporo Medical University School of Medicine, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
| | - Makoto Osanai
- Department of Pathology, Sapporo Medical University School of Medicine, S1 W17, Chuo-ku, Sapporo, 060-8556, Japan
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4
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Palmieri F, Koutsokera A, Bernasconi E, Junier P, von Garnier C, Ubags N. Recent Advances in Fungal Infections: From Lung Ecology to Therapeutic Strategies With a Focus on Aspergillus spp. Front Med (Lausanne) 2022; 9:832510. [PMID: 35386908 PMCID: PMC8977413 DOI: 10.3389/fmed.2022.832510] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/22/2022] [Indexed: 12/15/2022] Open
Abstract
Fungal infections are estimated to be the main cause of death for more than 1.5 million people worldwide annually. However, fungal pathogenicity has been largely neglected. This is notably the case for pulmonary fungal infections, which are difficult to diagnose and to treat. We are currently facing a global emergence of antifungal resistance, which decreases the chances of survival for affected patients. New therapeutic approaches are therefore needed to face these life-threatening fungal infections. In this review, we will provide a general overview on respiratory fungal infections, with a focus on fungi of the genus Aspergillus. Next, the immunological and microbiological mechanisms of fungal pathogenesis will be discussed. The role of the respiratory mycobiota and its interactions with the bacterial microbiota on lung fungal infections will be presented from an ecological perspective. Finally, we will focus on existing and future innovative approaches for the treatment of respiratory fungal infections.
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Affiliation(s)
- Fabio Palmieri
- Laboratory of Microbiology, Institute of Biology, University of Neuchâtel, Neuchâtel, Switzerland
- *Correspondence: Fabio Palmieri,
| | - Angela Koutsokera
- Faculty of Biology and Medicine, University of Lausanne, Service de Pneumologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Eric Bernasconi
- Faculty of Biology and Medicine, University of Lausanne, Service de Pneumologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Pilar Junier
- Laboratory of Microbiology, Institute of Biology, University of Neuchâtel, Neuchâtel, Switzerland
| | - Christophe von Garnier
- Faculty of Biology and Medicine, University of Lausanne, Service de Pneumologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Niki Ubags
- Faculty of Biology and Medicine, University of Lausanne, Service de Pneumologie, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
- Niki Ubags,
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5
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Hase I, Kagatani J, Suzuki S, Yoshida S, Sakamoto K, Maitani F, Horinouchi H, Kamei K, Tateno H. Successfully treated bronchopulmonary oxalosis caused by Aspergillus tubingensis in a non-neutropenic patient: A case report and review of the literature. J Infect Chemother 2021; 28:299-303. [PMID: 34756827 DOI: 10.1016/j.jiac.2021.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/11/2021] [Accepted: 10/21/2021] [Indexed: 11/17/2022]
Abstract
Pulmonary oxalosis can be fatal, and Aspergillus tubingensis is commonly resistant to azoles in Japan. We report a case of bronchopulmonary oxalosis caused by A. tubingensis in a non-neutropenic patient who was successfully treated with voriconazole monotherapy. The susceptibility of the isolates to voriconazole and the effective elimination of contagious necrotic tissue by expectoration seemed to be two major factors contributing to the patient's survival. According to the literature review, pulmonary oxalosis is associated with a high mortality rate over a short term. An exploration of detailed information about the genomic characteristics and drug susceptibility of Aspergillus isolates is important for the development of treatment strategies for this life-threatening disease.
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Affiliation(s)
- Isano Hase
- Department of Pulmonary Medicine, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan.
| | - Jin Kagatani
- Department of Pulmonary Medicine, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
| | - Shoji Suzuki
- Department of Pulmonary Medicine, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
| | - Shuichi Yoshida
- Department of Pulmonary Medicine, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
| | - Kei Sakamoto
- Department of General Thoracic Surgery, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
| | - Fumio Maitani
- Department of General Thoracic Surgery, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
| | - Hirohisa Horinouchi
- Department of General Thoracic Surgery, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
| | - Katsuhiko Kamei
- Medical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 60-8673, Japan
| | - Hiroki Tateno
- Department of Pulmonary Medicine, Saitama City Hospital, 2460 Mimuro, Midori-ku, Saitama City, Saitama, 336-8522, Japan
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Hattab J, Vulcano A, D’Arezzo S, Verni F, Tiscar PG, Lanteri G, Gjurcevic E, Tosi U, Marruchella G. Aspergillus Section Fumigati Pneumonia and Oxalate Nephrosis in a Foal. Pathogens 2021; 10:pathogens10091087. [PMID: 34578120 PMCID: PMC8471827 DOI: 10.3390/pathogens10091087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/24/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022] Open
Abstract
Equine pulmonary aspergillosis is a rare deep mycosis often due to the hematogenous spread of hyphae after gastrointestinal tract disease. We describe herein the main clinic-pathological findings observed in a foal, which spontaneously died after showing diarrhea and respiratory distress. Necropsy and histopathological investigations allowed to diagnose pulmonary aspergillosis, which likely developed after necrotic typhlitis-colitis. Biomolecular studies identified Aspergillus section Fumigati strain as the causative agent. Notably, severe oxalate nephrosis was concurrently observed. Occasionally, oxalate nephropathy can be a sequela of pulmonary aspergillosis in humans. The present case report suggests that the renal precipitation of oxalates can occur also in horses affected by pulmonary aspergillosis and could likely contribute to the fatal outcome of the disease.
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Affiliation(s)
- Jasmine Hattab
- Faculty of Veterinary Medicine, University of Teramo, Loc. Piano d’Accio, 64100 Teramo, Italy; (J.H.); (P.G.T.); (U.T.)
| | - Antonella Vulcano
- Laboratorio di Microbiologia Banca Biologica e Cell Factory, Istituto Nazionale Malattie Infettive “Lazzaro Spallanzani”, via Portuense 292, 00149 Rome, Italy; (A.V.); (S.D.)
| | - Silvia D’Arezzo
- Laboratorio di Microbiologia Banca Biologica e Cell Factory, Istituto Nazionale Malattie Infettive “Lazzaro Spallanzani”, via Portuense 292, 00149 Rome, Italy; (A.V.); (S.D.)
| | - Fabiana Verni
- Veterinary Practitioner, Loc. Convento, 64023 Teramo, Italy;
| | - Pietro Giorgio Tiscar
- Faculty of Veterinary Medicine, University of Teramo, Loc. Piano d’Accio, 64100 Teramo, Italy; (J.H.); (P.G.T.); (U.T.)
| | - Giovanni Lanteri
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, Viale G. Palatucci, 98168 Messina, Italy;
| | - Emil Gjurcevic
- Department for Biology and Pathology of Fish and Bees, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, 10 000 Zagreb, Croatia;
| | - Umberto Tosi
- Faculty of Veterinary Medicine, University of Teramo, Loc. Piano d’Accio, 64100 Teramo, Italy; (J.H.); (P.G.T.); (U.T.)
| | - Giuseppe Marruchella
- Faculty of Veterinary Medicine, University of Teramo, Loc. Piano d’Accio, 64100 Teramo, Italy; (J.H.); (P.G.T.); (U.T.)
- Correspondence: ; Tel.: +39-0861-266932
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7
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Aspergillus Section Nigri-Associated Calcium Oxalate Crystals in an Eurasian Eagle Owl ( Bubo bubo). Case Rep Vet Med 2018; 2018:3807059. [PMID: 29955435 PMCID: PMC6020650 DOI: 10.1155/2018/3807059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/11/2018] [Accepted: 05/20/2018] [Indexed: 11/17/2022] Open
Abstract
An adult male Eurasian eagle owl (Bubo bubo) housed at a wildlife rehabilitation facility in southern Oregon died after a short period of progressive ill-thrift. Radiographs taken prior to death demonstrated abnormal radiopaque material in the coelom and the owl was submitted for postmortem examination. Black pigmented fungus was noted grossly, particularly in the respiratory tissues, with abundant oxalate crystal deposition associated with and without hyphal elements subsequently observed histologically. Aspergillus section Nigri was cultured from the lesions. Although there have been a few reports of aspergillosis caused by Aspergillus niger in avian species, the severity and wide tissue distribution of oxalates in this case are highly unusual.
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Payne CL, Dark MJ, Conway JA, Farina LL. A retrospective study of the prevalence of calcium oxalate crystals in veterinary Aspergillus cases. J Vet Diagn Invest 2016; 29:51-58. [PMID: 27852812 DOI: 10.1177/1040638716672254] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Fungi in the genus Aspergillus are some of the most common fungal pathogens in veterinary species, primarily affecting the respiratory tract. In both human and veterinary cases, calcium oxalate crystals have been documented in sites of Aspergillus infection. Cases in multiple species (16 birds, 15 horses, 5 dogs, 1 ox, and 1 dolphin) were identified that had either positive cultures for Aspergillus sp., or had conidiophores present that could be identified as belonging to the genus Aspergillus. Histologic slides were examined to confirm the presence of oxalate crystals and how often they were identified on the original report. Calcium oxalate deposition was detected in 14 of 38 cases examined, including A. fumigatus, A. versicolor, A. niger, and unspecified Aspergillus sp. infections. Calcium oxalate crystals were identified in 11 of 16 avian cases, as well as in 1 of 1 bovine, 1 of 15 equine, and 1 of 5 canine cases. Crystals were described in only 3 of the 14 original pathology reports of these cases, indicating that identification and reporting of crystals in histologic specimens could be improved. All the tissues with crystals were respiratory tissues with air interfaces, including nasal sinus, trachea, syrinx, lung, and air sac. In cases with crystals identified on H&E-stained sections, crystals were frequently not present or were fewer in number in tissue sections stained with Gomori methenamine silver and periodic acid-Schiff. Routine polarization of slides of fungal infections, especially in the respiratory tract, should be considered to check for calcium oxalate crystals.
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Affiliation(s)
- Courtney L Payne
- Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - Michael J Dark
- Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - Julia A Conway
- Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - Lisa L Farina
- Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL
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9
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Wages PA, Cheng WY, Gibbs-Flournoy E, Samet JM. Live-cell imaging approaches for the investigation of xenobiotic-induced oxidant stress. Biochim Biophys Acta Gen Subj 2016; 1860:2802-15. [PMID: 27208426 DOI: 10.1016/j.bbagen.2016.05.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 05/11/2016] [Accepted: 05/12/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Oxidant stress is arguably a universal feature in toxicology. Research studies on the role of oxidant stress induced by xenobiotic exposures have typically relied on the identification of damaged biomolecules using a variety of conventional biochemical and molecular techniques. However, there is increasing evidence that low-level exposure to a variety of toxicants dysregulates cellular physiology by interfering with redox-dependent processes. SCOPE OF REVIEW The study of events involved in redox toxicology requires methodology capable of detecting transient modifications at relatively low signal strength. This article reviews the advantages of live-cell imaging for redox toxicology studies. MAJOR CONCLUSIONS Toxicological studies with xenobiotics of supra-physiological reactivity require careful consideration when using fluorogenic sensors in order to avoid potential artifacts and false negatives. Fortunately, experiments conducted for the purpose of validating the use of these sensors in toxicological applications often yield unexpected insights into the mechanisms through which xenobiotic exposure induces oxidant stress. GENERAL SIGNIFICANCE Live-cell imaging using a new generation of small molecule and genetically encoded fluorophores with excellent sensitivity and specificity affords unprecedented spatiotemporal resolution that is optimal for redox toxicology studies. This article is part of a Special Issue entitled Air Pollution, edited by Wenjun Ding, Andrew J. Ghio and Weidong Wu.
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Affiliation(s)
- Phillip A Wages
- Curriculum in Toxicology, University of North Carolina at Chapel Hill, NC, USA
| | - Wan-Yun Cheng
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA; Integrated Systems Toxicology Division, National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC, USA
| | - Eugene Gibbs-Flournoy
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA; Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC, USA
| | - James M Samet
- Environmental Public Health Division, National Health and Environmental Effects Research Laboratory, Research Triangle Park, NC, USA.
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Ando T, Tochigi N, Gocho K, Moriya A, Ikushima S, Kumasaka T, Takemura T, Shibuya K. Pathophysiological Implication of Computed Tomography Images of Chronic Pulmonary Aspergillosis. Jpn J Infect Dis 2016; 69:118-26. [DOI: 10.7883/yoken.jjid.2015.028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Tsunehiro Ando
- Department of Infectious Disease, Japanese Red Cross Medical Center
- Department of Surgical Pathology, Toho University Omori Medical Center
| | - Naobumi Tochigi
- Department of Surgical Pathology, Toho University Omori Medical Center
| | - Kyoko Gocho
- Department of Respiratory Disease, Toho University Omori Medical Center
| | - Atsuko Moriya
- Department of Infectious Disease, Japanese Red Cross Medical Center
| | - Soichiro Ikushima
- Department of Respiratory Disease, Japanese Red Cross Medical Center
| | | | | | - Kazutoshi Shibuya
- Department of Surgical Pathology, Toho University Omori Medical Center
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11
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Watanabe A. [Deep-seated mycosis]. Med Mycol J 2015; 56:J1-2. [PMID: 25855022 DOI: 10.3314/mmj.56.j1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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12
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Requena L, Sitthinamsuwan P, Santonja C, Fernández-Figueras MT, Rodríguez-Peralto JL, Argenyi Z, Torrelo A, Cerroni L, Kutzner H. Cutaneous and mucosal mucormycosis mimicking pancreatic panniculitis and gouty panniculitis. J Am Acad Dermatol 2012; 66:975-84. [DOI: 10.1016/j.jaad.2011.06.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Revised: 06/14/2011] [Accepted: 06/16/2011] [Indexed: 11/29/2022]
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13
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14
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Rassaei N, Shilo K, Lewin-Smith MR, Kalasinsky VF, Klassen-Fischer MK, Franks TJ. Deposition of calcium salts in a case of pulmonary zygomycosis: histopathologic and chemical findings. Hum Pathol 2009; 40:1353-7. [PMID: 19454361 DOI: 10.1016/j.humpath.2009.01.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2008] [Revised: 01/12/2009] [Accepted: 01/20/2009] [Indexed: 10/20/2022]
Abstract
We report a case of pulmonary zygomycosis associated with unusual deposition of calcium salt crystals. The patient was a 75-year-old female who had onset of cough and shortness of breath. She was treated for community-acquired pneumonia but died despite intensive therapy. Postmortem examination revealed diffuse alveolar damage and multifocal necrotizing pneumonia associated with herpes simplex infection and invasive zygomycosis. Birefringent particles were seen associated with fungal elements in the lung parenchyma, within bronchial cartilage, and in blood vessel walls. By infrared spectroscopy, the birefringent particles in the pulmonary parenchyma and within bronchial cartilage had spectral characteristics of calcium oxalate dihydrate and calcium oxalate monohydrate, respectively. The birefringent crystals within vascular walls were identified as calcium carbonate. This case documents the chemical composition and location of 3 different calcium salt crystals in pulmonary zygomycosis. It also shows that among pulmonary fungal infections, calcium oxalate deposition is not restricted to aspergillosis.
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Affiliation(s)
- Negar Rassaei
- Department of Pulmonary and Mediastinal Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA
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15
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Roehrl MHA, Croft WJ, Liao Q, Wang JY, Kradin RL. Hemorrhagic pulmonary oxalosis secondary to a noninvasive Aspergillus niger fungus ball. Virchows Arch 2007; 451:1067-73. [PMID: 17786471 DOI: 10.1007/s00428-007-0487-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2007] [Revised: 07/24/2007] [Accepted: 07/24/2007] [Indexed: 10/22/2022]
Abstract
We report a case of hemorrhagic pulmonary oxalosis secondary to a noninvasive Aspergillus niger fungus ball. A patient with cavitary lung disease and hemoptysis developed progressive lung infiltrates and intractable metabolic acidosis leading to death. At autopsy, aspergillomas were identified in both the right upper and middle lobes surrounded by a large rim of necrotic and hemorrhagic parenchyma. Microscopic examination showed extensive crystal deposition and vascular thrombosis. Fungal growth was limited to the intraluminal mycelia, and no tissue or blood vessel invasion was present. Remote crystal deposits were also localized in the absence of fungal organisms to the contralateral lung and to the tubules of both kidneys. The crystals were birefringent in polarized light and stained with colloidal iron. X-ray powder diffractometry and electron impact ionization mass spectrometry identified the crystals as calcium oxalate monohydrate. Furthermore, non-necrotizing granulomatous lesions were identified in the lungs, liver, and spleen, consistent with sarcoidosis, and may have predisposed this patient to developing pulmonary aspergillomas.
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Affiliation(s)
- Michael H A Roehrl
- Department of Pathology and Laboratory Medicine, James Homer Wright Pathology Laboratories, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
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16
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Chtourou I, Bahri Zouari I, Gouiaa N, Fakhfakh I, Charfi S, Hadj Kacem A, Sellami Boudawara T. Oxalose et aspergillose pulmonaires nécrosantes : à propos de deux observations. J Mycol Med 2007. [DOI: 10.1016/j.mycmed.2007.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Modem RR, Florence RR, Goulart RA, Pantanowitz L. Pulmonary Aspergillus-associated calcium oxalate crystals. Diagn Cytopathol 2006; 34:692-3. [PMID: 16955481 DOI: 10.1002/dc.20517] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Rukmini R Modem
- Department of Pathology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA 01199, USA.
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Gifford AH, Lahey T, Fordham Von Reyn C. Fatal hemoptysis from invasiveAspergillus nigerin a patient with cavitary lung disease andMycobacterium avium complexinfection. Med Mycol 2006; 44:557-60. [PMID: 16966174 DOI: 10.1080/13693780600575635] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Invasive aspergillosis typically afflicts immunocompromised patients, whereas pulmonary aspergilloma is a recognized complication of pre-existing cavitary lung disease in immunocompetent hosts. In both cases, the most prevalent pathogens are Aspergillus fumigatus and Aspergillus flavus. We describe a case of fatal hemoptysis from invasive Aspergillus niger infection in the setting of bullous lung disease, steroid-treated sarcoidosis, and Mycobacterium avium complex infection. This report highlights the potential for A. niger to cause invasive disease in conjunction with other pathologic processes in the lung.
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Affiliation(s)
- Alex H Gifford
- Section of General Internal Medicine, Section of Infectious Disease and International Health, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.
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Abstract
Oxalosis (calcium oxalate deposition) is associated with various conditions, including aspergillosis. Some Aspergillus species produce oxalic acid, which reacts with blood or tissue calcium to precipitate calcium oxalate. Calcium oxalate crystals exhibit various shapes and are strongly birefringent. These occur in cytological specimens, as well as in tissues of patients with Aspergillus infection. Aspergillus species are hyaline septate moulds, and they can be accurately recognized in pathology specimens only if conidial heads (fruiting heads) are present. When these structures are not observed, detection of associated oxalosis in a mould infection supports the pathological diagnosis of aspergillosis. The presence of oxalosis is helpful when microbiological identification or immunohistological techniques for fungi are not available. Calcium oxalate crystals can induce cellular injury by several mechanisms, and there is increasing evidence that oxalosis-induced tissue damage may occasionally lead to a poor clinical outcome. This review discusses the diagnostic value and the potential clinical significance of oxalosis associated with aspergillosis.
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Affiliation(s)
- Uğur Pabuççuoğlu
- School of Medicine, Department of Pathology, Dokuz Eylül University, Inciralti-Izmir, Turkey.
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Dogan M, Pabuçcuoglu U, Sarioglu S, Yücesoy M. Isolated Nasopharyngeal Aspergillosis Caused by A flavus and Associated with Oxalosis. EAR, NOSE & THROAT JOURNAL 2004. [DOI: 10.1177/014556130408300513] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report a case of isolated nasopharyngeal aspergillosis in a 52-year-old woman with Hashimoto's thyroiditis. We found the nasopharyngeal lesion incidentally while evaluating bilateral cervical lymphadenopathy, which we had discovered during a routine follow-up examination pursuant to the patient's thyroid problem. Biopsy analysis of the nasopharyngeal lesion revealed the presence of a mycelium made up of septate hyphae and associated oxalosis. Mycologic examination confirmed that Aspergillus flavus was the responsible pathogen. No systemic involvement or involvement of other head and neck sites was found. The patient had been exposed to a considerable amount of dust during the construction of her house, and this may have been the precipitating factor in the development of her infection. We treated the patient with a 4-week course of itraconazole. At the end of therapy, she exhibited no evidence of A flavus on physical and mycologic examinations.
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Affiliation(s)
- Müzeyyen Dogan
- From the Department of Otorhinolaryngology–Head and Neck Surgery, Dokuz Eylül Üniversity School of Medicine, Izmir, Turkey
| | - Ugur Pabuçcuoglu
- Department of Pathology, Dokuz Eylül Üniversity School of Medicine, Izmir, Turkey
| | - Sülen Sarioglu
- Department of Pathology, Dokuz Eylül Üniversity School of Medicine, Izmir, Turkey
| | - Mine Yücesoy
- Department of Microbiology and Clinical Microbiology, Dokuz Eylül Üniversity School of Medicine, Izmir, Turkey
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Procop GW, Johnston WW. Diagnostic value of conidia associated with pulmonary oxalosis: evidence of an Aspergillus niger infection. Diagn Cytopathol 1997; 17:292-4. [PMID: 9316786 DOI: 10.1002/(sici)1097-0339(199710)17:4<292::aid-dc10>3.0.co;2-j] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Bronchoalveolar lavage (BAL) material is commonly received in cytopathology for the exclusion of microorganisms. When crystalline material suggestive of calcium oxalate is present in the specimen, a search for fungal elements should be undertaken. Aspergillus niger is the hyaline mold associated with the presence of oxalate crystals. Commonly fragments of hyphae and occasionally entire conidiophores may be present in BAL specimens from patients with aspergillosis. We report a case of a patient with saprophytic colonization of a bullous/cavitary lesion. The BAL consisted of abundant acute inflammation, crystalline material suggestive of oxalate, and darkly pigmented conidia. Although an extensive search was undertaken, hyphal fragments could not be found. The suspicion of an A. niger infection was confirmed by culture. We believe that even in the absence of hyphal fragments, darkly pigmented, occasionally rough-walled conidia are sufficient evidence to be highly suspicious of an A. niger infection in patients with pulmonary oxalosis.
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Affiliation(s)
- G W Procop
- Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA
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